Toxicology

Check for Drugs
Carbon Monoxide
Check for Poisons
Check for Volatiles
Check for Alcohol
Collection and Submission of Evidence
Labeling Evidence

The Toxicology Section provides five primary services:

Tests for drugs in biological fluids and tissues (i.e. blood, urine, liver, etc.)
Tests for carbon monoxide in blood
Tests for poisons in biological fluids, tissues and source materials
Tests for volatiles (gases and vapors) in biological materials
Tests for alcohol content in biological fluids, tissues and liquids

Test for Drugs (return to top)

NOTE: This service is not performed on traffic cases unless blood alcohol concentration is less than 0.08 gm % or involves a death and has been requested.

These tests are used in a large number of case types to address one of the following questions:

Did the victim die of a drug overdose?
Was the suspect’s behavior influenced by the presence of alcohol or drugs?
Was the victim taking a prescribed medication as directed? (e.g. Was the anticonvulsant concentration in the blood too low?)
Was the subject driving while affected by a controlled substance or a potentially impairing drug?
Is the person negative for detectable amounts of the drugs analyzed?

Examples of case types commonly requiring the test for drugs service:

Unattended deaths – cause unknown
Drownings DUI/Drugs cases
Fire deaths
Homicides
Motor vehicle crashes
Seizure-related cases
Sudden Infant Death Syndrome (SIDS) cases
Suicides
Suspected overdoses

Carbon Monoxide (return to top)

Test for carbon monoxide is the test for the most frequently found poison – carbon monoxide. This service may be requested in order to address the following questions:

Did the victim die before or during a fire?
Was the person exposed to a sufficient concentration of carbon monoxide to influence behavior or cause death?
Was carbon monoxide a factor in influencing the behavior of a driver in a motor vehicle crash?

Case types commonly involving test for carbon monoxide requests:

Accidental death from combustion engine exhaust
Suicide from automobile exhaust
Fire deaths
Homicides (fire related)
Improperly used heating/cooking devices
Improperly vented/operating heating systems
Motor vehicle accidents

Test for Poisons (return to top)

Poisonings may involve a large list of potential substances, however, the classical poisons which continue to be of interest are arsenic, cyanide and strychnine. Other poisons include pesticides, miscellaneous substances such as cleaning solutions (disinfectants, radiator cleaner, etc.), volatile liquids, and gases. This service relates to those cases involving:

Cause of death unknown – possible poisoning/suspicious circumstances
Attempted poisoning, substance known or found, and motive possibly identified
Victim known to abuse illicit alcohol – possible lead poisoning
Lead poisoning suspected from source other than alcohol (i.e. child cases involving lead paints)
Strongly suspect arsenic poisoning – clinical lab results may be positive, source of arsenic may have been identified, and suspect and motive may have been identified
Suicide from cyanide/strychnine poison with containers present at scene and indicators of suicidal orientation present

Case examples involving test for poisoning requests:

Accidental poisoning
Attempted homicides/suicides
Homicides
Suicides

Test for Volatiles (return to top)

The check for volatiles service is the most recently defined service although it has been available for many years. This test may be used to answer the following questions:

Was the suspect driving while intoxicated by a volatile substance?
Did a gas (e.g. nitrous oxide/propane or natural gas/butane) asphyxiate the victim?
Did the victim succumb from toxic effects of the volatile solvent or gas (e.g. Trichloroethane or Freon)?

Case examples involving test for volatiles requests:

DUI suspects with gas/vapor delivery paraphernalia
Victims possessing gas/vapor paraphernalia or witnesses indicating volatile substance abuse
Cases involving suspected therapeutic overdoses
Exposure to volatile compounds on the job or in the home

Alcohol Determination (return to top)

The Toxicology Section also performs alcohol concentration determinations on biological fluids, tissues and liquid specimens. Biological specimens must involve cases resulting from suspected violation of the Uniform Rules of the Road, Boating Under the Influence, or cases arising from a death investigation. Liquid specimens can be analyzed for alcohol concentration or proof.

Blood Alcohol

Analysis of blood to determine alcohol concentration results is reported in compliance with the legal definition of alcohol concentration in O.C.G.A. All blood samples will be submitted in DOFS approved Blood Alcohol Collection Kits. Alcohol determinations will not routinely be performed on urine samples.

Proof

Analysis of liquid samples to determine alcohol concentration or proof.

Alcohol Content

Analysis of biological specimens other than blood or urine for alcohol concentration is performed. In death investigations blood and urine may be unsuitable for analysis or not available for collection. In these cases other possible specimens would include vitreous humor, bile, or tissues (e.g. liver, kidney, etc.). Results maybe reported as alcohol content in grams per 100 ml. or else “positive” or “negative” for alcohol. Decomposition of biological samples may produce alcohol and the interpretation of alcohol concentration in these specimens is problematic.

Collection, Packaging and Submission of Evidence (return to top)

Collect toxicology samples as soon as possible after the offense – in death cases before embalming. Package specimens in well-sealed, leak-proof containers surrounded with absorbent materials – biological specimens are a potential biohazard. Blood tubes should be sealed and kept cold, but DO NOT FREEZE. Refer to previous information for Safety Considerations in Packaging/Handling Biohazards. NEVER expose specimens to hot temperatures in back windows or trunks of vehicles.

Labeling (return to top)

For a valid chain-of-custody, all items of evidence must be labeled with the following information:

Name of victim or suspect
Initials or name of specimen collector
Date and time collected

The most important reason for submitting complete and descriptive information to the laboratory is to ensure that the submitter receives the best possible service for the particular case. The laboratory is guided by the information submitted.

A Submission Form must be submitted for each case with complete and descriptive information provided – this does not have to be lengthy, but it must be informative! For example: “GSW or gunshot wound” is much more informative than “suicide”. Remember: The information you receive from the laboratory will reflect the completeness of the information you submit to the laboratory.

Specimen Minimum Samples

The laboratory requirements for submitting samples are as follows:

Blood	Two 7 cc (or larger) grey-stoppered tubes (14 cc total minimum)
Urine	Approximately 30 cc in plastic, screw-capped bottle
Vitreous or Bile	Minimum 1 cc in grey-stoppered tubes
Stomach Contents	A large plastic container of appropriate volume, sealed well (too much is better than an insufficient quantity)
Lung Tissue	Place in a sealed well (e.g. paint can), or sealed glass jar, of one pint or one quart volume and freeze (DO NOT use plastic containers)
Kidney/Liver	Approximately 5 grams, unembalmed if possible
Hair	Collect two bundles of head hair ¼ inch in diameter (approximate thickness of pencil) and maximum length possible (cut close to scalp), tie off with a string or a rubber band and label the root end. If victim is deceased, remove roots with the hair.
NOTE: It is better to collect too much of a sample rather than too little. Biological Sample Requirements for Specific Toxicological Services
DUI/Drugs*	Blood Urine *Submission Form required on all suspected marijuana DUI cases
Drugs/Poisons	Blood Urine Gastric Contents RED-stoppered tubes should be used for blood when Fluoride, as in some radiator cleaners, or a pesticide, such as Parathion is the suspected agent. NOTE: Whenever the poisonous agent suspected is considered to be unusual and special packaging may be necessary – PLEASE CALL THE LABORATORY AND SEEK ASSISTANCE.
Gases or Volatiles	Blood Lung Tissue Propellant cans, glues, towels/rags, or gas cylinders which are suspected sources should be collected and immediately placed in a sealed container to prevent loss of volatile substances. These items should be submitted to the laboratory with the biological samples.
Arsenic	Urine (without preservative) Hair Suspected source materials such as ant poison, weed killer, and suspect foodstuffs Gastric contents (if available) Kidney and liver (if available) Nails pulled from the root NOTE: In most instances, blood is not an appropriate specimen for arsenic testing.
Carbon Monoxide	Blood – there must be red blood cells present (hemolyzed or non-hemolyzed) NOTE: Whole blood is the only appropriate biological specimen for carbon monoxide. Blood serum is unacceptable because it does not contain red blood cells.
Cyanide	Blood Gastric contents Suspected source material such as potassium, cyanide or suspected foodstuffs
Strychnine (return to top)	Blood Urine Gastric contents (if available) Liver (if available) Any source material such as rodent poison or suspected foodstuffs

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